Implementation requires new approaches to care

No matter what your political affiliation may be, the debate continues in earnest over the U.S. Supreme Court’s decision to uphold the constitutionality of the Affordable Care Act.

While health care professionals, academics and everyday citizens debate the law’s fabric and related issues, the unavoidable fact is that the health care system is changing. Health care reform will continue to be in the public spotlight through 2014 and likely beyond.

A recent poll conducted by the Siena Research Institute of Siena College indicates that a majority of voters (45 percent to 28 percent) agree with the court’s decision on the constitutionality of the act.

Fifty-three percent of voters want to see the law fully implemented, while 37 percent want to see it repealed. Three-quarters of Democrats favor implementation of the law and three-quarters of Republicans support repeal. According to the poll, one in five voters believes the law will increase health care access, while only one in eight thinks the law will reduce medical expenses.

By 2014, the health care system will have more than 30 million new members; consequently, delivering quality, cost-effective health care is imperative. Insurers face the added challenge of accommodating this influx in a way that doesn’t further drive up the cost of care.

A concern is the law’s health insurer tax provision, which takes effect in 2014. This provision will add as much as $400 a year to family premiums by 2016. The tax will disproportionately affect small businesses, families and individuals.

Health insurance companies like BlueCross BlueShield of Western New York — and the country as a whole —must continue to focus on the underlying costs of health care. The only way to bend the trend is to focus on the drivers of health care costs: soaring prices for medical services; costly new prescription drugs and medical technologies; unhealthy lifestyles; and an outdated fee-for-service system that pays for volume rather than value.

BlueCross BlueShield is working to remedy these situations through the following partnerships and initiatives:

• Partnering with the Kaleida Health system to reward quality care and achieve better outcomes for patients.

• Partnering with Kaleida, the Catholic hospitals, Erie County Medical Center and other hospitals to reduce hospital-acquired infections and readmissions for the same condition.

• Helping members better manage chronic diseases with information and support from our nurse case managers.

• Providing comprehensive information to doctors to help them manage their patients’ chronic diseases.